- Universal Health Services, Inc. (Temecula, CA)
- …Southwest Healthcare Regional office in Temecula, CA is seeking a Full -Time Central Utilization Review Nurse who will be responsible for carrying out ... ensure correct payer source for hospitalization and communication. Ensures compliance of utilization review practices as required by payers, external regulatory… more
- Universal Health Services, Inc. (Temecula, CA)
- …in an acute care hospital Case Management/Discharge Planning/ Utilization Review experience preferred Completion of an accredited Registered Nursing ... program Current California Registered Nurse license CCM and/or CPUR certification preferred CPI Certification within the first 90 days This opportunity offers the following: Challenging and rewarding work environment Growth and development… more
- ERP International (San Diego, CA)
- **Overview** ERP International is seeking a full -time ** Registered Nurse ( RN ) Health Educator** supporting **Naval Medical Center San Diego, CA ... management/prevention. Lead position requires at least 4 years experience Licensure:** Current, full , active, and unrestricted RN license from any state. Life… more
- Alameda Health System (Oakland, CA)
- …each individual in the classification. Lead and manage a team of utilization review professionals providing guidance, training, and performance evaluations. ... reviews and determine program improvements. Develop and implement utilization review policies and procedures in accordance...Required Licenses/Certifications : Valid license to practice as a Registered Nurse in the State of California.… more
- Stanford Health Care (Palo Alto, CA)
- …affect the processes and outcomes of patient health care **Licenses and Certifications** + Nursing\ RN - Registered Nurse - State Licensure And/Or Compact ... | Stanford Health Care (SHC)? Are you a seasoned RN Case Manager? Here is your opportunity to work...include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review … more
- Universal Health Services, Inc. (Corona, CA)
- …Minimum of 3+ years strongly preferred. Certifications/Licenses: Current license as a Registered Nurse in the State of California required. Current ... our website at www.swhealthcaresystem.com. Job Summary: Southwest Healthcare is seeking a Full -Time RN Clinical Documentation Integrity Specialist for our Corona… more
- AmTrust Financial (Irvine, CA)
- …personalized holistic approach for each claim. These responsibilities may include utilization review , pharmacy oversight and care coordination. Responsibilities ... Telephonic Nurse Case Manager - California RN ...every level, are medically necessary and appropriately delivered. Perform Utilization Review activities prospectively, concurrently or retrospectively… more
- UnitedHealth Group (Cypress, CA)
- …Join us to start Caring. Connecting. Growing together. As a Clinical Appeals RN for UHC Clinical Services, you will work on post-service appeals for Medicare-based ... claims. Primary Responsibilities: Review provider post-service appeals for Medicare and Retirement Gather...Required Qualifications: Undergraduate degree or equivalent experience Unrestricted, active RN license 2+ years of RN experience… more
- San Francisco Health Plan (San Francisco, CA)
- …environment, required. 2+ years supervisory/management experience, required. An active, unrestricted Registered Nurse ( RN ) license in California, required. ... Reporting to the Sr Medical Director, the Nurse Manager, Quality Review provides leadership...years of related experience in acute care, case management, utilization management, or quality improvement. 3+ years in managed… more
- Stanford Health Care (Palo Alto, CA)
- …Lead APP also functions under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), or the ... and adherence to policy through practice analysis and case review of APPs with physicians. . Investigate and respond...under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered Nurse… more
